1. Canadian Community Health Survey – Cycle 2.2 (2004) – Nutrition
Larry MacNabb
Health Statistics Division
Statistics Canada
APHEO

2. CCHS Goal
Provide reliable, timely information about dietary intake, nutritional wellbeing and their key determinants to inform and guide programs, policies and activities of federal and provincial governments as well as local health agencies.

3. CCHS Objectives
Estimate the distribution of usual dietary intake in terms of foods, food groups, dietary supplements, nutrients and eating patterns among a representative sample of Canadians at national and provincial levels.
Measure the prevalence of household food insecurity among various population groups in Canada.
Gather some anthropometric measurements for body weight measurement.
Collect data on selected health conditions and socio-economic and demographic characteristics of respondents.

4. Sample Design Objectives
estimate the distribution of usual dietary intake in terms of food, food groups, dietary supplements, nutrients and eating patterns for the following 15 key domains of interest (Dietary Reference Intakes age groupings X sex):
< 1 All
1-3 All
4-8 All
9-13 M/F
14-18 M/F
19-30 M/F
31-50 M/F
51-70 M/F
71 + M/F

5. Target Population Target population for the survey
individuals living in private occupied dwellings in the ten provinces
Exclusions: those living on Indian Reserves and Crown Lands, residents of institutions, full-time members of the Canadian Armed Forces and residents of some remote areas
The Nutrition survey component covers approximately 98% of the Canadian population living in the provinces

6. Sample Allocation Total sample size: 30,000 responding units
Two-step approach
Step 1
1,120 units for each province (80 for each of the 14 DRI/sex groupings)
Note: the minimum 0f 80 units is not a requirement for the < 1
Step 2
The remaining 18,800 units are allocated to the provinces using a power allocation scheme with a power q=0.70

7. Frames Area Frame CCHS 2.1 Frame Buy-ins
Off-Reserve Aboriginals – National – CCHS 2.1
PEI (top-up) – PEI Health Registry
Ontario (7 Regions) – CCHS 2.1
Manitoba (Children in 4 regions) – MB Health Registry

8. Data Collection
Four quarterly samples from January December 2004
60-minute CAPI interview including the 24-hour recall and physical measures for half the sample
Anticipated response rate: 80%
(85% for fresh sample and 75% for 2.1 sample of households)
To allow for the calculation of the intra-individual variability
A second 24-recall for a subsample of 10,000 units (CATI) 3 to 10 days after the first interview preferably a different day of the week
A minimum of 125 individuals for each of the 15 DRI/sex groupings by Region (Atlantic, Quebec, Ontario, Prairies, BC)

9. Content 24 – Hour Dietary Recall General Health Questionnaire
USDA Automated Multiple Multiple Pass Methodology
General Health Questionnaire

10. 24 Hour Dietary Recall
All foods eaten from midnight to midnight for the previous day
Details
Amounts
Computer application developed by United States Department of Agriculture
In conjunction with Health Canada modified to represent Canadian marketplace
Translated into French

11. Automated Multiple Pass Methodology
5 step method designed to improve a respondents’ chances of recalling all foods eaten during the previous 24 hour period:
Quick List
Forgotten Foods
Time and Occasion
Detail Cycle
Final Probe

12. General Health Questionnaire
*General Health (age 12+)
*Physical Activity (age 12+)
Sedentary Activity (age 12 – 17)
Measured Height and Weight (age 2+)
Self Reported Height and Weight (10% sample, age 18+)
Vitamin and Mineral Supplements (all)
Household Food Security (all)
Children’s Physical Activity (age 6 to 11)
Fruit and Vegetable Consumption (age 6 mo.+)
Women’s Health (women age 9+)
*Chronic Conditions (all)
*Smoking (age 12+)
*Alcohol Consumption (age 12+)
*Socio-Demographics (all)
*Labour Force (age 15 – 75)
Income (all)

13. Age-Specific Interview Protocols
12+ - Non-Proxy
6 to 11 – Assisted-Proxy (parent and respondent)
5 and Under – Proxy (parent only)

14. Data Quality – Response Rates
1st Interview
2nd Interview
Overall
Area Frame
Other Frames
Canada
76.5
75.9
77.2
72.8
72.3 NL
83.3
84.6
80.5
79.9
81.7 PE
79.2
80.4
78.3
84.3
82.8 NS
78.6
77.5
75.8 NB
75.7
75.0
81.4 PQ
74.8
77.1
80.3 ON
72.7
71.6
73.9
67.1
64.8 MB
82.7
82.1
83.5
70.0
70.5 SK
75.5
79.5
70.7 AB
77.4
76.6
73.2 BC
76.2
61.9
60.4

15. Data Quality – Number of Respondents
First Interview
Second Interview
Canada
35107
10786 NL
1734
752 PE
1430
860 NS
1705
704 NB
1633
683 PQ
4780
1964 ON
10921
1647 MB
4194
921 SK
2041
894 AB
3021
767 BC
3648
1564

16. Total Respondents by Age, 1st Interview, Canada and Provinces – CCHS 2
<1
1-3
4-8
9-13
14-18
19-30
31-50
51-70
71+
Canada
35107
289
2302
3359
4194
4766
3984
5689
6142
4382 NL
1734 16 85
132
211
223
182
331
406
148 PE
1430 9 63
113
175
173
188
247
290
172 NS
1705 15
118
179
219
245
192
272
321
144 NB
1633
104
147
174
216
292
341
156 QC
4780 34
325
505
579
685
517
846
913
376 ON
10921 84
705
988
1208
1325
1070
1557
1799
2185 MB 46
349
443
560
623
478
669
632
394 SK
2041 12
135
218
231
300
238
316
343
248 AB
3021 26
183
295
366
430
474
542
481
224 BC
3648 32
235
339
471
546
457
617
616
335

17. Total Respondents by Age, 1st Interview Ontario – CCHS 2.2
<1
1-3
4-8
9-13
14-18
19-30
31-50
51-70
71+
Ontario
10921 84
705
988
1208
1325
1070
1557
1799
2185
Southwest
1660 16
101
144
186
192
163
220
257
381
Central South
1351 17 98
103
155
159
110
166
238
305
Central West
1712 14
108
183
198
223
234
242
272
Central East
1591 6 99
150
209
197
114
249
266
301
Toronto
1383
105
148
139
165
158
221
196
245
East
1526 95
116
140
241
327
North
1698 11
188
162
226
351
354

18. Total Respondents by Age, 2nd Interview, Canada and Provinces – CCHS 2
<1
1-3
4-8
9-13
14-18
19-30
31-50
51-70
71+
Canada
10786 65
768
755
1546
1569
1463
1512
1617
1491 NL
782 6 43 58
133
102 89
140
110
101 PE
860 2 51 50
131
103
137
132
117 NS
704 4 60 48 93 96
123 84 79 NB
683 1 46 53 87 95 80
109 QC
1964 13
142
290
270
269
289
261 ON
1647 9
211
198
207
238
296 MB
921 47
167
141
154
104 SK
894 88 73
146
155 99
106
136 AB
767 7 49
108
120
112 BC
1564 12
118
234
222
180
247
178

19. Total Respondents by Age, 2nd Interview Ontario – CCHS 2.2
<1
1-3
4-8
9-13
14-18
19-30
31-50
51-70
71+
Ontario
1647 9 96
123
211
198
207
238
269
296
Southwest
247 1 16 14 30 27 26 33 44 56
Central South
190 12 20 18 35 41
Central West
263 31 36 29 48 34
Central East
236 2 13 10 19 38 25 53
Toronto
203 15
East
233 3 11 17 32 22 37 39
North
275 63 45

20. Data Quality – Measured Height and Weight (%)
Total NL PE NS NB PQ ON MB SK AB BC
Measured – H/W 63 71 68 73 62 55 61
Refused 11 14 10 13 7 9 18 12
Respondent Not Available 6 4 5
Resp. too Tall 2
Equipment (NA, batteries) 1 8
Phone Interview 3
Interview Setting
Physical/Mental Condition
Data not stated
Other

21. Phase 1 Release – July 6, 2005 Internet Publication CANSIM tables
Nutrition: Findings from the Canadian Community Health Survey
Adult Obesity
Childhood Obesity
CANSIM tables
Adult Measured BMI
Child Measured BMI
Food Insecurity
Children’s Physical Activity
Teenage Sedentary Activity

22. Measured Obesity Rates by Age Canada Health Survey - 1978/79, CCHS - 2004* * * * * * * * F F

23. Adult (aged 18+) Self-reported Chronic Condition Prevalence by Weight Class CCHS - 2004* * * * * * * * * * F F

24. Obesity Rate Over Time, Age 18+ 1978/79 – 2004
Measured
Self-reported

25. Adult Percentage Distribution of BMI (age 18+) 1978/79 and 2004

26. Fruits and Vegetables Physical Activity * * *
Adult Obesity Rates (Age 18+) by Fruit and Vegetable Consumption and Leisure Time Physical Activity CCHS
Fruits and Vegetables
Physical Activity * * *

27. Obesity Rate Over Time, Age 12 to 17 1978/79 – 2004
Measured
Self-reported

28. Teenage Percentage Distribution of BMI (age 12-17) 1978/79 and 2004

29. Obesity/Overweight Rate, Ages 2 to 5 & 6 to 11 1978/79 – 2004

30. Childhood Overweight and Obesity Rates (Age 2 to 17) by Fruit and Vegetable Consumption CCHS - 2004* *

31. Daily Screen Time Weekly Screen Time * * *
Childhood Overweight and Obesity Rates (Age 6 to 17) by Daily (Age 6 to 11) and Weekly (Age 12 to 17) Hours of Screen Time CCHS
Daily Screen Time
Weekly Screen Time * * *

32. Ontario Measured Obesity Rates by Age and Region, 2004 CCHS 2.2
45+
18 to 44
Overall
2 to 17

33. Phase 2 Release Currently assigning food codes to ~ 750,000 records
In colloboration with Health Canada coding to Canadian Nutrient File
Nutritional profiles for each food will then be calculated using a processing system designed by Health Canada for provincial nutrition surveys
Plan on releasing early 2006
Release approach will be similar to phase 1
Articles
CANSIM Tables

34. Microdata Outputs 4 files General Health and Nutritional Summary data
Vitamin and Mineral supplement details
1 record per supplement reported
Food details file
1 record per food reported
Day 1 and 2 Intake summary file
1 record per intake day
1 record for 2/3 of respondents, 2 records for 1/3 of respondents

35. Roll Up

36. Nutrition Variables Protein Fat (total lipids) Carbohydrate, total
Energy (kilocalories)
Alcohol
Mositure
Caffeine
Energy (kilojoules)
Sugars (total)
Fibre, total dietary
Calcium
Iron
Magnesium
Phosphorous
Potassium
Sodium
Zinc
Vitamin D (IU)
Vitmin D (MCG)
Vitamin C
Thiamin
Riboflavin
Total Niacin Equivalent
Vitamin B6
Total Folacin
Vitamin B12
Folic Acid
Cholesterol
Fatty Acids, Saturated, Total
Fatty Acids, Polyunsaturated, 18:2, Linoleic
Fatty Acids, Polyunsaturated, 18:3, Linolenic
Fatty Acids, Monounsaturated, Total
Fatty Acids, Polyunsaturated, Total
Naturally Occuring Folate
Retinol Activity Equivalents
Dietary Folate Equivalent

37. Intake Adjustment – Total Calories Consumed, Males Age 31 to 50 United States , CSFII ( , 1998)
σTotal = σInter Individual + σIntra Individual

38. Unadjusted – 15.1% Adjusted – 4.6%
Proportion of Males Age 31 to 50 Consuming Calories United States , CSFII ( , 1998)
Unadjusted – 15.1%
Adjusted – 4.6%

39. Training/Support/Other
Proper use of files
Use of intake distribution software
Health Canada – interpretation guide
Working with CIHR on an RFA process to fund researchers to analyse the data
Working with STC Agriculture Division to compare data with consumption data

40. Questions ?

41. Contact Information
Larry MacNabb
Project Manager
Canadian Community Health Survey
Phone: (613)